The Mary Babb Randolph Cancer Center (MBR) at West Virginia University will improve cancer prevention and control in the northern Appalachian region by establishing community-based coalitions to develop, implement, maintain, and evaluate long-range, comprehensive, multi-disciplinary and community-wide projects. MBR's primary partner is the Pittsburgh Cancer Institute (PCI), the only NCI-designated Comprehensive Cancer Center in the northern Appalachian region. MBR and PCI will work with the-Riverside Regional Cancer Institute in Columbus, Ohio; Marshall University in Huntington, WV; and Lourdes Hospital Regional Cancer Center in Binghamton, NY. MBR and its partners will establish approximately 30 coalitions in the northern Appalachian region which is defined as all of West Virginia, and counties in Pennsylvania, New York, Ohio, Maryland and Virginia. We will integrate the activities of related national cancer programs such as the American Cancer Society the Cancer Information Service, the Centers for Disease Control Breast and Cervical Cancer Mortality and Prevention Program, and the American Stop Smoking Intervention Study (ASSIST) with those of NALIC. In each state we will work closely with such groups as the education and health departments, extension services, church groups, hospitals, and the Area Health Education Centers to ensure full integration into the community. Our target population is all Appalachians with a special emphasis on minorities, low-income, low literacy, and medically underserved. In Year I of NALIC, we will train regional coordinators, identify appropriate communities for coalitions, and identify lay and professional leaders to serve on the coalitions. In Years II through V, MBR and its partners will assist the coalitions to implement and evaluate their cancer control projects.